Provider Demographics
NPI:1740166461
Name:ABERNATHY, PAIGE ANNE (RDN, LD)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:ANNE
Last Name:ABERNATHY
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 VENDEMMIA BND
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-1166
Mailing Address - Country:US
Mailing Address - Phone:512-826-4211
Mailing Address - Fax:
Practice Address - Street 1:8101 CAMERON RD STE 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-3816
Practice Address - Country:US
Practice Address - Phone:512-766-9979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT07334133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered